(a). Field of the Invention
This invention relates to the holding of tracheostomy tubes and like medical devices and more particularly, but not by way of limitation, to a tracheostomy tube dressing and support unit.
(b). Discussion of Prior Art
The two concerns of a healthcare provider with reference to a tracheostomy tube and like medical tubes are 1. secure anchorage of the tube and 2. maintenance of the insertion site wound in the neck. To date, these two needs have been addressed by separate devices. This invention relates to a one piece unit which provides for both medical concerns.
At present, the tracheostomy tube is held in place by one of two concepts. The first is narrow, shoe-lace like cotton tape which wraps around the neck and ties to opposite sides of the tracheostomy tube flange. This technique has failings related to:
1. Danger of constriction of the airway or the blood supply to head by the rope-like tape. PA1 2. Irritation to the neck by the rubbing of the narrow band of material which worsens as the duration of the usage lengthens. In addition, as the tape becomes encrusted with secretions and drainage from around the tube, the tape looses it's softness and flexibility. PA1 3. The securing knots may come undone which lead to the danger of the life saving tracheostomy tube becoming dislodged and the airway lost. PA1 4. Difficult to adjust for comfort since there is a fine line of comfort vs. proper constriction for a secure application of the tube. Each time the tape must be untied, rethreaded and retied. PA1 a. A side (of the neck) opening and closure point by means of a hook fastener set of tabs which attach anywhere to the material itself. Excess material can be cut off for "custom sizing". PA1 b. The width of the material wrap which encircles the neck is wide enough (23/4 to 6 inches) to give a comfortable application without any rolling of the edges from excess width. PA1 c. A window opening to allow the tracheostomy tube and flange to adequately, but yet securely slip through. PA1 d. At each side of the window opening, 1/2 inches from the window edge, is attached a hook fastener strap, 21/2.times.3/8 inches, sewn hook side up, which points toward the window opening. Each strap is then threaded through openings in the opposite sides of the tube's flange. The strap then is folded back over itself to securely and firmly attach to a loop fastener landing pad, 1/2 inches circular, at a distance of 11/2 inches from the edge of the window opening on it's respective side. This permits quick, easy, firm and adjustable anchoring of the tracheostomy tube itself. PA1 e. The subject support device includes hook fastener tabs to be attached by adhesive or permanently attached to an underside of the wrap and next to opposite sides of the window opening. These hook fastener tabs will then secure around the tube itself any primary wound dressing that the health care provider may choose to use to manage the tracheostomy wound. PA1 a. A means to secure a tracheostomy tube which is 1. washable PA1 2. reusable 3. hypoallergic 4. adjustable 5. bi-directional 6. customizable 7. incomparably safe. PA1 b. Able to secure and maintain any primary wound dressing simultaneously to the tracheostomy tube wound.
A second technique involves the use of velcro straps which slip through the opposite sides of the tube flange, but which are part of a minimally flexible, non-washable, non reusable band. This band for supporting tracheostomy tubes in described in U.S. Pat. No. 4,331,144 to Wapner.
Neither of the above mentioned techniques provide for attention to the second need by the heathcare provider, i.e., the maintenance of the wound at the insertion site.
In U.S. Pat. No. 5,456,660 issued to the subject inventor and Dr. Marshall Reich, a wound dressing support device is described for holding a variety of standard dressings in place on top of an open wound. The support device includes an elongated elastic unidirectional wrap with a window opening therein. This support device does not address the holding of a tracheostomy tube in place and the maintenance of the tube insertion site.
U.S. Pat. No. 4,732,146 to Fasline et al. discloses a surgical wound dressing device having a frame with an opening for receiving different types of wound dressings. A dressing is held in place by straps attached to one side of the frame with one end of the straps including releasable Velcro fasteners.
U.S. Pat. No. 4,917,112 to Kalt describes a bandage having an opening with the opening covered with a transparent membrane. The membrane is designed to allow air and vapors to permeate outward from the wound and prevent contaminants from entering in the opposite direction.
In U.S. Pat. No. 4,909,243 to Frank et al., a two piece wound dressing is shown having an adhesive layer on one side of a baseplate with an opening in the baseplate to expose the wound and the epithelium area around the wound. A second adhesive layer on one side of a wound pad secures a wound dressing above the opening in the baseplate.
U.S. Pat. No. 4,907,579 to Kum, U.S, Pat. No. 5,167,613 to Karami et al., and U.S. Pat. No. 3,779,242 to McCullough disclosed different types of adhesive bandages for providing open areas to wounds to enhance healing. In U.S. Pat. No. 5,036,838 to Sherman, a foam plastic orthopedic fabric is described having a Velcro tab at one end of the fabric.
In U.S. Pat. No. 4,470,410 to Elliott a stretchable sleeve is shown with Velcro fasteners at the ends of the sleeve. The sleeve includes a central opening with a releasable flap for retaining an intravenous tube or the like.
U.S. Pat. Nos. 4,709,695 to Kohn et al., 4,399,816 to Spangler, 5,086,763 to Hathman, and 4,926,883 to Strock all describe different types of wound surrounding dressings and bandages. Also U.S. Pat. Nos. 4,190,054 to Brennan and 4,658,811 to Beaird disclose stretchable bandages having loop and hook type attachment ends for encircling the head of a patient.
None of the above mentioned prior art patents disclose the unique structure and advantages of the subject invention as described herein when addressing the need of a tracheostomy tube dressing and support device for holding a tube in place and at the same time holding a primary dressing next to the tube insertion site.